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They provide passive bonuses, but only one can be held one at a time. The collectible item Mom's Purse allows two trinkets to be kept at once, but not two of the same trinket. The held trinket is displayed in a slot in the upper left portion of the screen.

Once a trinket drops, it can drop again, but has a very low chance and the trinket dropped will appear reversed (except Mom will still drop the Polaroid at 100% even if you already have it). If all trinkets have dropped, Tarot Cards will start dropping in their place.

List of Trinkets

Name & Image

Effect

Info

???'s Soul

Gives you a Familiar that looks like Brother Bobby and floats slowly around the room on a pattern similar to The Peeper, shooting long-range spectral homing tears that have high Shot Speed.

If you have other familiars, they will follow ???'s Soul instead of Isaac. This does not include Orbitals, Blue Flies, or stage 3/4 Meat Boy and the body created by The Pinking Shears.

This item is meant to be unlocked by completing The Chest with ???. However, due to a bug it is instead unlocked by completing The Chest with Eve.

Ace Of Spades

Increases the chance of Tarot Cards or Suit Cards dropping after clearing a room, and the chance of finding Cards when opening a Chest.

Hearts dropped through the use of this trinket will always be Half Hearts, and are not affected by items such as Mitre or being spawned in special rooms such as Cathedral Super Secret Rooms.

Effective trinket for Blood Donation Machine use, as the money dropped by the machine will often create a Half Heart, effectively making that use "free". This is even more pronounced with the IV Bag, since it is possible to create as many as four coin drops per Half Heart spent via the item.

The effective fire rate increase varies depending on Isaac's current Tears stat. The higher the Tears stat, the higher the percentage increase in fire rate from Cancer. See the Tears section on the stats page for detailed calculation.

Child's Heart

Increases the chance of a Heart dropping after clearing a room, and the chance of finding a Heart when opening a Chest.

Chance of finding a Heart when clearing a room is increased by 10%.

Chance of finding a Heart when opening a Chest is increased by 66%.

Hearts dropped due to this trinket are treated as normal heart drops: they have a small chance to appear as Soul Hearts or Eternal Hearts. Items such as Mitre or Mom's Pearl will affect this chance.

Counterfeit Penny

Gives a 50% chance of increasing the value of every coin pickup by one. Can only be found in Golden Poop.

If Isaac has less than one full Red Heart after taking damage, he will be immediately teleported to the last cleared room he was in.

The Cursed Skull only counts Red Hearts, and does not count Soul Hearts or Eternal Hearts. Even if the triggering damage is absorbed by a Soul Heart or Eternal Heart, Isaac will still be teleported if he has half a Red Heart or less.

Due to the above, ??? will be teleported any time he takes damage while holding this trinket, as will any character who has reduced their heart count to zero via other means.

Rather than increasing the Damage stat, the Curved Horn increases the Effective Damage of Isaac's tears. Because the Damage stat increases Effective Damage by smaller and smaller amounts with each increase, this makes the trinket considerably more valuable at higher levels of the Damage stat. See Damage on the stats pages for a detailed calculation.

Eve's Bird Foot

5% chance to spawn a Dead Bird familiar for the current room each time an enemy dies.

This item is meant to be unlocked by completing The Chest with Eve. However, due to a bug it is instead unlocked by completing The Chest with ???.

When playing as ???, this Trinket will generate a spirit heart when you gain the health up effect from Odd Mushroom (large). This spirit heart does not disappear when you exit the room. This effect only applies once per playthrough.

Lucky Toe

Increases the chance to get a drop after clearing a room. Although the Luck stat also influences this, it does not actually increase the Luck stat.

The increase in drop chance is applied before the effect of Guppy's Tail.

Increases the chance of a generic drop from clearing a room by roughly 10%, the same amount increased by the Lucky Foot item. If Isaac's Luck stat is not negative, this raises the chance of an item dropping from 86.6% to 96.3%.

If Isaac also has the Lucky Foot and his Luck stat is not negative, the chance for a drop is only increased by 2% instead. This raises the chance of an item dropping to 98.3%.

If Isaac has a negative Luck stat and the Lucky Toe with or without the Lucky Foot, there is a 100% chance that an item will drop after clearing a room.

Grants a secondary 10% chance of any non-specific Heart drop turning into a Soul Heart.

The secondary chance triggers whenever a non-specific Heart drops which does not become an Eternal Heart or Soul Heart. It is applied after Eve's secondary 6.25% chance, but before Mitre's secondary 50% chance.

By itself, Mom's Pearl raises the chance of a non-specific Heart dropping as a Soul Heart from 9.8% to 18.62%. Combined with Eve's bonus, the chance becomes 23.58%. Combined with Mitre, the chance is 58.31%. Combined with both Mitre and Eve's bonus for the highest possible bonus, the chance is raised to 60.79%.